Plenary, 07 Oct 2004

Meeting date: Thursday, October 7, 2004

Official Report 396KB pdf

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First Minister's Question Time

Before questions to the First Minister, members will want to welcome the honourable Noel Cringle, President of Tynwald in the Isle of Man, and a large delegation of members and staff from state legislatures across the United States of America. [Applause.]

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Cabinet (Meetings)

I take the opportunity to welcome Margaret Ewing back to the chamber. [Applause.]

To ask the First Minister what issues will be discussed at the next meeting of the Scottish Executive's Cabinet. (S2F-1118)

I will resume my new habit in this building, from which I took a break last week, by noting that Kathleen Jamie, a poet from Fife, whose style has been compared to that of Robert Burns, has won the Forward poetry award. As today is national poetry day, it seems entirely appropriate to note that a Scot has won that award this year. Patricia Ferguson will be writing to her. [Applause.]

At this afternoon's Cabinet meeting, we will discuss matters of importance to the people of Scotland.

I add my warm congratulations to Kathleen Jamie on a well-deserved tribute.

Last week, the emergency surgery unit at St John's hospital in Livingston closed. Does the First Minister believe that that will improve the quality of care for patients in West Lothian?

I believe that, when the people who are responsible for such matters locally give us their expert opinion that they have had to make a decision in the interests of the safety of patients, we should not overrule that decision.

Last night, I visited a woman in West Lothian. The story that she told me paints a very different picture to the one that the First Minister has painted in this chamber on previous occasions.

Two weeks ago today, she had a hysterectomy at St John's hospital in Livingston. She was discharged three days later, but last Tuesday, the day after the emergency surgery unit at St John's closed, she was rushed back to hospital by ambulance. Because there was no longer an emergency surgery unit at St John's, she had to be shipped to Edinburgh's royal infirmary, where she spent 11 hours in pain on a trolley and another 12 hours—still in pain—in an assessment unit, waiting for a bed to be found. I am sure that the staff did their level best, but it took 23 hours for that woman, who—let us not forget—had undergone major surgery less than a week earlier and who was in severe pain, to be admitted to a ward. That was all because, two days earlier, the Executive had allowed the emergency surgery unit at her local hospital, where she could have been treated quickly and close to home, to shut its doors.

Will the First Minister please explain to that patient how his policy has improved her quality of care?

Nobody would be surprised to hear that I would be deeply distressed to learn that that had been the case. Obviously, I would want to consider the individual case. If we are going to make political points about it, I would want to know exactly what treatments were required.

It is a human point, Jack.

I am very concerned about the human point—that is exactly my point, in fact. The individual concerned should be at the centre of our concerns. I would of course want to examine not only the circumstances of that individual case but whether the decision that Lothian NHS Board made last week, on the advice of medical experts, had an impact on it. If that is the case, it is a matter that Lothian NHS Board will have to consider. I would be equally concerned if what was regarded as an unsafe level of provision at St John's had been continued, thereby perhaps making that individual's condition even worse. It is important that we consider those matters rationally and that we take the expert opinion. I will certainly look into that individual case but I will also ensure that, when we consider it, we consider the hard facts and ensure that Lothian NHS Board learns the right lessons.

That lady also told me last night that, when she complained about her predicament to the staff at Edinburgh royal infirmary, they told her to take it up with the politicians because, they said, it was politicians who were closing hospital wards. She took it up with me, and now I am taking it up with the First Minister. Is it not the case that the Executive's health policy is failing patients, failing hospital staff and failing Scotland? The question that the First Minister has failed to answer is why. So, First Minister, why?

I would be very happy to quote Ms Sturgeon in answering why. On 28 May last year she said that

"hospitals do need to be modernised. Some degree of centralisation of services is sensible"—

Ah.

Twenty-three hours, Jack.

Let me finish. Nicola Sturgeon said:

"Some degree of centralisation of services is sensible for medical reasons…".

It is important that, rather than seek to capitalise politically on the challenges of the health service, we seek instead to find the right solutions for the health service. There are challenges in our health service, and there are, at times, local proposals for excessive centralisation. When that has happened, the Executive and successive health ministers have acted. However, there is also an important case for change, for the decentralisation of services and for the reallocation of resources to ensure that that can happen, and there is a need for the highest quality of service.

It is precisely because patients have to have a voice—not just through their politicians but through their own representatives—that we have in the past week improved the patient involvement measures in our national health service with the establishment of the new Scottish patient council. It is vitally important that patients have a voice themselves, as well as through the Executive. The new measures that Malcolm Chisholm announced last Saturday in his final act as Minister for Health and Community Care will ensure that patient representation is improved in future.

Centralisation that results in a woman in pain waiting 23 hours to be admitted to a ward is not acceptable in anybody's language. What the people of Scotland are waiting for is not a change of face, but a change of the policy that results in that kind of scandal in our hospitals. They are still waiting for the First Minister to answer the simple question: why is it happening?

Increasing specialisation is happening where it saves lives in modern Scotland. It is happening so that the people of modern Scotland can have the best technology, the best skills and the best-trained doctors, consultants and nurses available to save their lives and allow them to live longer.

I have said to Ms Sturgeon that I will look into the individual case that she has raised, and it will be followed through by our health ministers. The policy of decentralising services right across Scotland to the most local level possible, while ensuring at the same time that specialised services are provided to the highest possible quality, is important for the lives of the people of Scotland. That is a policy that we intend to improve upon and to further.

Does the First Minister agree that the experience that Ms Sturgeon has related to us is unacceptable? I recognise that the First Minister will consider the matter further. Does he also agree that my constituents in West Lothian deserve the highest quality of care wherever it might be provided; that the issues of transport—although they are acknowledged to be difficult—are side issues compared to that of a quality of care that can be delivered only in certain places; and that it is unacceptable for Ms Sturgeon to use a constituent of mine in the way in which she has done today?

If the distressing story that Ms Sturgeon has recounted here today is true—

Oh!

I am not about to say here in the chamber that I will not look into individual cases when they are raised with me as First Minister. If the story is indeed true, it is a distressing case that requires not just my looking into it, but action to be taken by Lothian NHS Board to ensure that the standards that we expect are met. That will be our clear intention. It is important to ensure that, throughout the Lothians, and indeed throughout the wider east of Scotland, we have the highest quality of care, both in local centres and in the centres of excellence. As I said recently, the changes that are taking place at St John's hospital and elsewhere are changes that, in many cases—in relation both to services at St John's and to the quality of care provided in the specialist centres—save lives. I know that only too well.

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Prime Minister (Meetings)

To ask the First Minister when he will next meet the Prime Minister and what issues will be discussed. (S2F-1115)

I have no immediate plans to meet the Prime Minister.

They might get round to discussing financial matters when they do meet. The First Minister will be aware that Professor Arthur Midwinter told the Parliament's Finance Committee this week that, on the basis of the financial settlement for local authorities,

"it would not be surprising if there were council tax increases above the level of inflation".—[Official Report, Finance Committee, 5 October 2004; c 1749.]

It seems that, yet again, the First Minister and his Scottish Executive are going to be responsible for hitting our hard-pressed council tax payers, particularly those on fixed incomes, such as pensioners.

Council tax has already risen by 50 per cent since 1997, which is double the rate of inflation. Instead of forcing councils to raise council tax, why does the First Minister not use some of the budget increases that his Executive boasts about to enable councils to cut council tax for everyone, right across the board? Is it not the case that, under the Scottish Executive, council tax has become the ultimate stealth tax and that there is no end in sight to increase upon increase?

I absolutely share David McLetchie's concern for council tax payers in Scotland. The difference is that we have acted on that concern and have done so consistently. In every single year since the Parliament was established in 1999, the level of council tax increase in Scotland has been significantly below the last three council tax increases under the Conservative Government that was booted out of office in 1997 for precisely this kind of reason: inefficiency, waste, misdirected priorities and high tax increases to pay for incompetence. I am proud of this Parliament's record of having lower council tax increases every single year since 1999 compared with the increases under the Conservative Government back in the 1990s. I give a clear signal today that we expect council tax increases to be as low again next year, the year after and the year after that. There is absolutely no reason whatever why the settlement announced last week by Andy Kerr should cause council tax increases to be above 2.5 per cent. Any council in which there is a rise above that should be operating its business more efficiently.

I was interested to hear the First Minister raising the subject of efficiency, or inefficiency, in this context. The truth is that the First Minister's so-called efficiency savings programme is a joke. As we know from bitter experience, councils will react to tighter grant settlements by either cutting front-line services or raising council tax, or both. The whole efficiency savings programme is a complete sham. The same Professor Midwinter of whom I spoke earlier told the Parliament's Finance Committee this week that the efficiency savings identified by HM Government as part of the Gershon review were three times greater than the Scottish target. Yet the First Minister tells us that when it comes to efficiency savings we will go further than south of the border. Mr McCabe, our new Minister for Finance and Public Service Reform, refused to confirm that the other day. He told the committee:

"If people want to compare what we achieve up here with what happens down south, that is their business."—[Official Report, Finance Committee, 5 October 2004; c 1758.]

One of the people making comparisons with the south is the First Minister. Will he do so again and guarantee that our efficiency savings will be greater than those proposed by HM Government?

When we announce the full package of efficiency savings Mr McLetchie might regret raising the topic, because it will show just how efficient we are determined to be. The key point that Mr McLetchie made in his first statement was that a tight financial settlement necessarily leads to increases in council tax or reduction in front-line services. That may well have happened in the Tory years, but it does not need to happen today in 21st century Scotland. With the measures that we will promote and the measures that local authorities should implement, local authorities should ensure through the settlement that their rises in council tax do not go above 2.5 per cent per annum. There is no reason for that to happen and I hope that we can work with local authorities to ensure that it does not.

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Secretary of State for Scotland (Meetings)

To ask the First Minister when he will next meet the Secretary of State for Scotland and what issues he intends to discuss. (S2F-1134)

I have no immediate plans to meet formally the Secretary of State for Scotland.

Yesterday's report from HM chief inspector of prisons must have made fairly dismal reading. Does the First Minister agree with the Association of Directors of Social Work figure that 83 per cent of adult prisoners have no aspect of their offending behaviour addressed while they are in prison? Does he agree that that is an embarrassing indictment of the partnership agreement's so-called commitment to reduce reoffending and a major reason why we have overcrowded jails and offenders living in grossly degrading and unjust conditions? Why is the Executive failing so badly and what is the First Minister going to do?

I do not want to comment on individual quotes from organisations when I do not know the full context. Throughout the criminal justice system there is a key responsibility on the social work profession as well as politicians and those responsible for the prison service. That is precisely why we intend to bring those services closer together to ensure that they work together to reduce reoffending in Scotland. Although the action that we propose to improve our prisons, build new prisons and ensure that we end slopping out is important, it is also important that we provide the right services in our communities and prisons to stop the reoffending that has plagued Scotland for too long.

If social work services were funded better than they are at present they might be able to cope with the workload and the disposals that the children's panel system and prison system would like to give them. At present 650 young offenders are in jail, 72 per cent of whom are likely to be reconvicted within two years. Does the First Minister agree with the Association of Directors of Social Work that the Executive has a naive confidence that punishment through deprivation will reform, that not enough is being done and that what little is being done is not good enough and is not followed through? It is vital that disposals and help given to prisoners in jail and people in young offenders institutions be followed through after they have left. What is the First Minister going to do?

If that were true, I would, of course, be deeply concerned. However, it is of course not true. In the five years since devolution, the level of expenditure in the area that we are discussing has doubled because we understand that it is so important that it requires improved action at local and national level. I have no doubt about the sincerity of Robin Harper's point about the need to tackle reoffending with structured programmes when people are in custody and once they have been released. I entirely agree with him on that point. That is precisely why we have significantly increased resources and it is also precisely why there must be structural change. We cannot continue to have a situation in which 32 authorities, the prison service and others in the system operate in separate and distinctive ways. There must be a better co-ordinated and more systematic approach across Scotland. When we have that, we will be able to reduce reoffending.

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Sectarianism

To ask the First Minister what action the Scottish Executive is taking to tackle sectarianism. (S2F-1122)

Scottish ministers are tackling sectarianism in a number of ways, including support for initiatives, such as the sense over sectarianism campaign, and for groups such as the Scottish Inter Faith Council and Nil by Mouth. We are developing an anti-sectarianism education pack, which will be launched early next year and we are tackling sectarianism in sport with football clubs and others. We have also commissioned a review of marches and parades.

I hope that the pilot programme that is being rolled out will build on the work that has been done in schools in my constituency, such as Law primary, on building tolerance and mutual respect for children of all ages and religious faiths. What is being done to tackle the sectarianism that is far more deeply rooted than simple football affiliation?

We believe that, as well as tackling the sectarianism that exists in a minority—although it is a too significant minority—of our adult population, we need to change the behaviours and attitudes of future generations. It is important that we use the tougher laws that this Parliament has agreed, that we enforce those laws effectively, that we try to change the atmosphere around our two major football clubs in particular and that, in our schools, we encourage the tolerance, respect and understanding that there should be among people who come from different religious backgrounds. I believe that we can achieve that across Scotland and I welcome Karen Gillon's support for that aim.

Would the First Minister develop the good things that he has already said by publicising more intensively the fact that 110 people have already been found guilty of offences aggravated by religious hatred? That is a good step forward on the part of the police and the courts. Would he consider involving in this issue the problem of hatred of the Jewish and Muslim communities arising from all the troubles in the middle east? They must be defended as well as those who suffer from sectarian hatred.

As I have said before, not only do we need to tackle the traditional sectarianism that has existed in some Scottish communities but we have to ensure that we encourage a spirit of tolerance of and respect for other religions as well. During the Iraq war last year, Scotland showed that it is possible for our educators, police forces, public agencies and private individuals to come together to promote tolerance and understanding and to stand up for minority religious groups that might face bullying or abuse in the playground and elsewhere. I would like us to follow that example again in the years to come.

Does the First Minister accept that, as Mr Gorrie has indicated, sectarianism can manifest itself in ugly incidents throughout our communities and that, unless we have more police officers in our communities, the measures that he has mentioned are rendered nugatory as there will be no power to detect a breach of law and enforce the law in our communities?

I do not know whether Annabel Goldie was listening to Donald Gorrie's question, which was based on the fact that dozens of people have already been found guilty of offences aggravated by religious hatred. That is an indication of the work that is being done by police forces throughout Scotland. They have the time and resources to do that work, first because their numbers are at record levels, and secondly because we have an on-going commitment, which is making a material difference on the ground in communities throughout Scotland, to release more police to operational duties, year on year. That is happening as a result of changes in the prison service and in how the police service is organised. I notice that the Conservatives have criticised some of those changes again this week, but if they really support more police officers on the beat and are not just talking about it, they need to back the changes and reforms that are required.

I welcome any measures to tackle racism and bigotry, but will the First Minister clarify the pilot scheme that is being rolled out in schools and nurseries? Is it a website? Is its use at the discretion of teachers and is there any in-service training on it for teachers in schools and nurseries? Also, in a week that has seen four public houses in Glasgow raided for putting up sectarian artefacts, why is Glasgow not one of the areas for the pilot scheme? To me, it makes more sense for the scheme to be run in Glasgow than in Dumfries, where teachers have said that they have no need for it.

I hesitate to mention my local area in this regard, but North Lanarkshire is one of the areas that has been chosen for the pilot scheme and I assure the member that I believe that it is an entirely appropriate choice for the project. It is important for us to educate children and allow them to develop their understanding in a variety of ways. There will not simply be a website, as somebody said earlier; perhaps we concentrate too much of our attention on websites. We need a variety of educational resources that are appropriate for different ages and that allow children to develop the ideas of tolerance and understanding that make such a difference.

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Health Policy

To ask the First Minister whether a change of Minister for Health and Community Care will mean that there is a change of health policy. (S2F-1131)

Ministers will continue with policies to improve our nation's health, to improve and modernise the national health service and to ensure that health services are as local as possible, wherever that can be done safely and sustainably. That is the policy of the Scottish Government and not of any one health minister.

As there will be no policy change, how will the First Minister explain to the people of Lanarkshire why they have to lose emergency surgery from Wishaw general hospital in his constituency, Hairmyres hospital in the constituency of the Minister for Health and Community Care, or Monklands hospital in the constituency of the Secretary of State for Health, John Reid? How on earth does he expect his constituents to take seriously the forthcoming public consultation on a national strategy for hospitals when, at the same time, Lanarkshire NHS Board is proposing cuts to those hospitals?

Actually, no, it is not. I do not know how anybody could take seriously the SNP's health policy, which is based on raising in this chamber speculation in newspapers as concrete fact and which bases a change of policy on such speculation and scaremongering. As I said earlier, the SNP's leader said last year that a degree of centralisation of services is sensible for medical reasons. We heard from Miss Robison in the chamber—last week and yesterday—and in the nationalists' press releases this week that there should be no changes in the national health service, but if there were no changes—[Interruption.]

I am making a serious point about Miss Robison's area. I know that Carnoustie is not in her constituency, but it is in the Tayside health board area. I think that the new primary health care centre in Carnoustie will matter to the people of Carnoustie and the people of Tayside, but it would be stopped in its tracks right now if the Government accepted the SNP's proposal for a moratorium. The centre is being built by a public-private partnership, so it would not even have got to the drawing board if the SNP was in charge of the devolved Government in Scotland.

We need a bit of consistency on health policy, based around the facts, from the Scottish nationalist party. People will get that consistency in health policy from the Labour and Liberal Democrat coalition. They will get a policy that delivers improvements in local health services as well as the safety that is required in specialisation.

Does the First Minister agree that the SNP's no-change policy is not in the interests of patients but is actually an attack on the safety of patients? Doctors are saying clearly that change is needed, certainly in Glasgow and, I suspect, elsewhere in Scotland. The forthcoming blockage in the necessary change in hospital services will be at the expense of the health service improvement that is desperately needed to improve the health of the people of Scotland. We have got to improve people's health. It is not all about hospitals; it is about doing things for ordinary people.

I agree absolutely that health improvement is important for the people of Scotland. Both Opposition parties have shown consistently their disregard for the importance of health improvement in Scotland, as well as for health service improvement. It is a problem for the so-called party of Opposition in Scotland that it seems to change its policy whenever it is possible for it to get the headlines. Last year, it officially supported the policy of rationalising health services and ensuring that the right services were delivered in the right locations. Now that there is a national campaign against some of those local proposals, the SNP has changed its party policy and has fallen in behind that campaign. It is sheer hypocrisy for the SNP to take that approach. I hope that we can get some more sense into the debate in the weeks ahead.

Is the First Minister aware that Glasgow and Lanarkshire are continuing to copy the flagship of Edinburgh royal infirmary—a building that was built to avoid blocked beds but which has gone wrong and now has 300 blocked beds? The tendency to use public-private partnerships means that we reduce the number of available beds. Is the First Minister prepared to change his policy or will he increase the number of essential hospital beds?

The problem with bedblocking in Lothian is not the number of hospital beds, but the number of places in the community for people who should not be in hospital beds. As I said yesterday, I believe that people who do not need to be in hospital—especially elderly people—should be in the community with their families, being properly supported by local government and other health service agencies. I believe absolutely that we need to improve the quality of provision in our local communities to support people when they are in care in the community. However, I also believe absolutely that, when people need hospital beds, they should have them.

Will the First Minister share with us the instructions that he gave to his new Minister for Health and Community Care about the devolution of decision making to local areas in the health service?

Now we hear the policy that says that we need to devolve more decisions—unless there is a headline to be made in opposing the devolution of decisions to local health boards.

There is a balance to be struck between the national strategy and policies of the health service—which should, rightly, be set in the Parliament by the devolved Government—and the decisions that should be made locally not just by health boards, but by the medical professionals and through engaging the patients who are, ultimately, at the centre of our service and should be even more so in the months and years ahead.

We need to ensure that the right decisions are made locally. However, as I said two weeks ago, it is important that the health boards, which have a statutory responsibility to make decisions in their areas, take into account in making those decisions the factors beyond their boundaries that influence services in other areas. That is an important development that needs to be taken on board by all the health boards in Scotland. I hope that they have heard that message loud and clear.

On a point of order, Presiding Officer. I apologise for raising the same point of order that I have raised for the past two weeks. As members will see, we have lost a question and First Minister's question time has run four minutes over the half an hour that is allotted to it. Do we accept that we are continually going to break our standing orders or do we update our standing orders? I would prefer to do the latter. Will the Presiding Officer give us some suggestions on how we might make sense of this item of business?

That is one of the matters on which I will reflect during the recess, once the Parliament has been opened on Saturday.